First Edition: July 9, 2013

Today's early morning highlights from the major news organizations, including a look at HHS Secretary Kathleen Sebelius' challenges and a delay in implementing insurance penalties on smokers.

Kaiser Health News: Some Doctors Questioning Whether Shorter Shifts For Interns Are Endangering Patients
Sandra G. Boodman, writing for Kaiser Health News in collaboration with The Washington Post, reports: "These days, interns, as first-year residents fresh out of medical school are known, no longer face the punishing shifts Casoy endured just four years ago. In July 2011, after more than two decades of impassioned debate, the Accreditation Council for Graduate Medical Education (ACGME) reduced the maximum allowable shift for the least experienced doctors from 30 straight hours to 16. ... But as a new class of interns, who arrived July 1, begins treating patients in teaching hospitals around the country, a recent spate of studies questions whether the rules have made the situation worse" (Boodman, 7/9). Read the story.

Kaiser Health News: Insuring Your Health: In Addition To Premium Credits, Health Law Offers Some Consumers Help Paying Deductibles And Co-Pays
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "For the plans being sold through the online health insurance marketplaces next year, much of the discussion has been on tax credits that can reduce the monthly premium for people with incomes up to 400 percent of the federal poverty level ($94,200 for a family of four in 2013). But the Affordable Care Act also established another type of financial assistance for people who buy plans on the marketplaces, also known as exchanges. Cost-sharing subsidies can substantially reduce the deductibles, copayments, coinsurance and total out-of-pocket spending limits for people with incomes up to 250 percent of the federal poverty level" (Andrews, 7/9). Read the column.

Kaiser Health News: Health Exchange Pitch To Sports Fans Started In Fenway
Colorado Public Radio's Eric Whitney, working in partnership with Kaiser Health News and NPR, reports: "It’s a Wednesday night in Boston, and Amy O’Leary is out at Fenway enjoying a Red Sox game and hoping for another year like 2007. That’s when the team won the World Series. ... It’s also the year that Massachusetts started requiring nearly all residents to have health insurance – and the Red Sox helped to get the word out about it. ... Now that other states are opening health insurance marketplaces, they’re trying the same strategy" (Whitney, 7/9). Read the story.

Kaiser Health News: Capsules: Researchers Look At Why Poor Patients Prefer Hospital Care
Now on Kaiser Health News blog, Ankita Rao looks at a study that explores where low-income patients seek health care: "Long wait times, jammed schedules, confusing insurance plans – there’s no shortage of obstacles between a patient and her doctor. That is, if she has a doctor. But a Health Affairs study published Monday says the barriers for poor people looking to get care are even higher, and it’s leading them away from preventive doctor visits and toward emergency rooms and costly, hospital-based care" (Rao, 7/8). Check out what else is on the blog.

The New York Times: Sebelius Defends Law And Zeal In Push To Insure Millions
[HHS Secretary Kathleen] Sebelius is on the defensive more than ever now that the White House has delayed a major provision of the law that requires larger employers to offer health insurance to full-time employees. Republicans say she has given a far too rosy picture of progress in carrying out the law. And they are demanding that she explain why people should be required to carry insurance next year if employers are not required to offer it. In her zeal to make the health care law work, Ms. Sebelius has tested the limits of her authority. After Congress refused to provide as much as she wanted for a nationwide campaign publicizing the new insurance options, she shuffled money between government accounts and sought cash from outside groups. Her actions have riled Republicans (Pear, 7/8).

The Associated Press: A Break For Smokers? Glitch May Limit Penalties
Some smokers trying to get coverage next year under President Barack Obama's health care law may get a break from tobacco-use penalties that could have made their premiums unaffordable. The Obama administration — in yet another health care overhaul delay — has quietly notified insurers that a computer system glitch will limit penalties that the law says the companies may charge smokers. A fix will take at least a year to put in place (Alonso-Zaldivar, 7/9).

The New York Times: What Does Birth Cost? Hard To Tell
We’re continually told that when it comes to health care, we need to be savvy and shop around for the best prices. To that end, policy experts and politicians promote health care savings accounts, saying they make “health care consumers” (a k a patients) more conscious of prices, bringing down the cost of medical care. Here is what happened to my daughter, Therese Allison, when she tried to be just the sort of shrewd and informed patient that politicians should love (Kolata, 7/8).

Los Angeles Times: Obama Urges Cabinet To Use Technology To Make Government Smarter
President Obama has told his staff to use all the technology at their disposal to make the federal government “smarter, quicker and more responsive” in his second term. ... Online shopping sites help users fill in some of their information so the consumer doesn’t have to do so every time, Obama said. Government forms on the Web should do the same, he said. In addition, people applying for federal benefits should be able to track the status of their applications in real time, just as they can follow delivery of a package to their doorstep, he said. The Obama administration recently started HealthCare.gov, which orients consumers on how to use the Web-based exchanges that will sell insurance and allows side-by-side comparisons of plans. Obama noted that when the prototype of the insurance application came in at 21 pages, his team rejected it. “It’s now three pages long,” he said. If the innovations seem incremental, that’s partly because Obama is resorting to changes he can make unilaterally, without the help of Congress (Parsons, 7/8).

The New York Times/CNBC: 10 Questions For Obama’s Chief Technology Officer (Video)
Todd Park, a former Silicon Valley entrepreneur, serves as President Obama’s chief technology officer. His role has taken on heightened importance after several recent developments, including the implementation of the new health care law, efforts to reduce the backlog in Department of Veterans Affairs claims processing, and privacy issues raised by disclosures about data collection by the National Security Agency. Mr. Park spoke with John Harwood of The Times and CNBC at the White House as Mr. Obama publicly challenged his administration to improve the government’s innovation and efficiency in his second term (Harwood, 7/8).

Politico: Study: Some On Medicaid Lose Out Under Obamacare
As millions of low-income adults gain access in just a few months to Medicaid coverage under Obamacare, those already in the program could be shut out of some of the key preventive services included in the law. And the new enrollees could have a hard time actually getting a doctor. Those are the findings of two Health Affairs studies published Monday. The health law requires most insurance plans to cover a set of preventive services, like cholesterol tests and mammograms, without cost-sharing. And that requirement extends to coverage for newly eligible Medicaid beneficiaries in states that choose to expand their programs, according to researchers Sara Wilensky and Elizabeth Gray of The George Washington University’s public health school. The same requirement, though, doesn’t apply to adults who already qualify for Medicaid, the researchers say. That means Medicaid enrollees living in the same state could have different experiences in the program (Millman, 7/8).

Politico: Health Sites May Be Sharing Search Terms
The National Security Agency is tracking your phone calls. And online snoops may be keeping tabs on your Internet health searches, too. And that includes use of terms such as “depression” or “herpes.” A research letter published Monday by JAMA Internal Medicine found that seven of 20 widely used health websites are passing on users’ searches to third parties. Those sending the information along include widely used free commercial websites like Health.com and Drugs.com, as well as popular news sites like The New York Times and Men’s Health Magazine. Most government sites and others closely tied to professional medical groups — the Food and Drug Administration, the National Institutes of Health and the Journal of the American Medical Association, for instance — do not (Norman, 7/8).

Los Angeles Times: More Doctors, Hospitals Use Electronic Over Paper Medical Records
Hospitals are increasingly switching from paper to electronic medical records but aren’t necessarily using them to improve the quality or efficiency of care, according to a new report by the Robert Wood Johnson Foundation. Forty-four percent of hospitals had basic electronic health records in 2012, up from 27% the previous year, according to the report. Overall, the number of hospitals using such medical records has tripled since 2010. Some of the biggest jumps occurred in rural hospitals, which increased from 1 in 10 in 2010 to 1 in 3 in 2012 (Gorman, 7/8).

The Associated Press: Thousands Flock To Texas Capitol Over Abortion
Texas Republicans pushed ahead Monday with aggressive efforts to pass tough new abortion restrictions they failed to approve last month, scheduling a House vote as thousands flocked to the Capitol for an anti-abortion rally and a marathon public hearing about the legislation. Activists for and against the proposed restrictions descended on the Capitol for the hearing that started at 10 a.m., wearing their signature colors. About 2,000 anti-abortion demonstrators in blue staged a Capitol evening rally that heavily invoked God and Biblical teachings (Vertuno, 7/8).

The Associated Press: Judge Blocks New Wisconsin Abortion Law
A federal judge issued a temporary restraining order Monday evening to block enforcement of a new Wisconsin law that bans doctors who lack admitting privileges at nearby hospitals from performing abortions. U.S. District Judge William Conley granted the order following a hearing in a lawsuit filed Friday by Planned Parenthood of Wisconsin and Affiliated Medical Services. It alleged the requirement would unconstitutionally restrict the availability of abortions in the state, violates the U.S. Constitution's due process guarantee and unconstitutionally treats doctors who perform abortions differently from those who perform other procedures (Bauer, 7/8).

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This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.